In March 2015, six medical students in Geisel's Urban Health Scholars program went to New Orleans for spring break to experience and learn about the city's challenging and distinct health care delivery system. They are sharing their experiences in several posts here on the Geisel Med Blog. You can find all their posts here.
Tour of ILH and University Medical Center
By: Dwan Pineros '18
Monday morning began with a visit to the Interim Louisiana State University Hospital (ILH) where we met with Susan Todd, Angela Davis-Collins, and Paolo Zambito. Susan Todd is executive director of 504HealthNet, an association of 22 non-profit and governmental organizations in the Greater New Orleans area that provides primary care and behavioral health services. Angela-Davis Collins is director of ambulatory care services at ILH and Paolo Zambito is senior vice president for strategy and business development at Louisiana Children's Medical Center (LCMC) Health.
After introductions, Paolo Zambito gave us a brief history about the healthcare system in New Orleans and about the legacy of Charity Hospital and University Hospital in particular. Charity Hospital was founded in the 18th century and, along with Bellevue Hospital in New York, was among the oldest hospitals in the United States. Because of its location at the heart of the city, the hospital had been instrumental in providing care to the inner city populations of New Orleans. When Charity Hospital was closed in the aftermath of Hurricane Katrina, the city’s residents suffered a great loss and University Hospital became the area’s only Level 1 Trauma Center.
University Hospital was opened by the Daughters of Charity more than a century after Charity Hospital was founded. The hospital was purchased by the Louisiana State University System and together with Charity Hospital became part of the Louisiana State University Health Sciences Center, a public entity. Like its sister hospital, University Hospital sustained severe damage during Hurricane Katrina, but was not closed. The hospital was renovated and reopened after the storm. The hospital, now called ILH, continues to serve the people of New Orleans and is the main teaching hospital for the LSU Health Sciences Center.
Amid state budget cuts that affected the seven public hospitals in south Louisiana including ILH, the government of Louisiana announced in 2013 that LCMC Health, a non-profit corporation that managed the Children’s Hospital and Touro Infirmary, would lease and take over management and operations of ILH and the $1.2 billion University Medical Center slated to open this spring. Both facilities will be staffed by LSU faculty and residents and will continue to serve the uninsured. This public-private partnership exemplifies the trend of consolidation and privatization seen in healthcare nationwide.
After our meeting, we were given a tour of ILH by Angela Davis-Collins. Our tour included a visit to different departments including the Emergency Department and the Level 1 Trauma Center at the main hospital. The most memorable part of the tour, however, was a visit to the Medical Center of Louisiana at New Orleans Clinics and Ambulatory Services a few blocks down. The range of services offered at the site was wide, ranging from general surgery to physical therapy, among others. The most notable aspect of the medical center, however, was that it was housed in a former Lord and Taylor department store.
As we toured the Lord and Taylor building, it was uncanny how vestiges of an up-scale department store remained in spaces that were now put to use for very different purposes. The carpeted entrance where sales racks once stood was now a patient registration and waiting area. Examination rooms lined the tiled walkways and were separated from the walkways by temporary walls. Fitting rooms were now office space and white cabinetry for merchandise display stood empty. The improvised use of the Lord and Taylor department store gave the impression that the premises were meant to be temporary and indeed they were when patients were first seen. A little less than a decade after Hurricane Katrina, it was startling to see an interim arrangement become a permanent fixture in the provision of healthcare. This was about to change with the opening of the new $1.2 billion University Medical Center.
After our tour of the Medical Center of Louisiana, we met with Jay Buras, vice president of operations at ILH. He gave us a tour of the impressive new facility. The University Medical Center is almost complete and will open later this spring. All of the departments and clinics at the Lord and Taylor building will have a new home in this complex. The difference between the two sites is night and day.
For example, we toured the department for Physical Medicine and Rehabilitation at the Lord and Taylor Clinic. The space was drab and felt cramped with a single corridor in between different exercise stations. The new home of the department was spacious and had a large window, which provided plenty of natural lighting. The atmosphere was much more welcoming and we could understand why the staff we had talked to earlier was eager and looking forward to the move.
As much as we delighted in the tour of University Medical Center, some of us wondered if some of the resources that went into this new facility could have been put to better use. For example, the facility can accommodate a much larger number of hospital beds and examination rooms, but this expanded capacity exceeds what is needed. Management will mitigate wasteful use of space by limiting the number of beds and work spaces each department can use. Another example is the installation of artwork in the main lobby that costs hundreds of thousands of dollars. In a state where budget cuts for healthcare and education are always imminent, it was hard to justify why a publicly funded hospital should install expensive artwork when so many other healthcare needs were unmet.
We felt privileged and very thankful to have been given a tour of ILH and the new University Medical Center by Angela Davis-Collins, Paolo Zambito, and Jay Buras. We hoped that the new facility will improve and advance medical care to the people of New Orleans in the spirit and mission of the old Charity Hospital.